I hereby release, acquit, covenant not to sue, and forever discharge Donna's Gym, Inc. DBA: South County Movement Center, its owners, officers, administrators, employees, agents, volunteers, sponsors, advertisers, coaches and supervisors, and the owners or lessors of any facilities within which the Activity is conducted, their respective agents and employees, and all other persons providing facilities or assisting in the conduct of the Activity and in the transportation of participants to and from the Activity (collectively the "Released Parties") of and from any and all actions, causes of action, claims, demands, liability, losses or damages of whatever name or nature including but not limited to those arising from or in any way related to the negligence of any of the Released Parties, that arise out of or are connected in any way to the gymnast's/ dancer's participation in the Activity and the transportation of the above named gymnast to and from the Activity (Collectively the "Released Claims").
I authorize Donna's Gym, Inc. DBA: South County Movement Center to provide to the participant through medical personnel of its choice, customary medical assistance, transportation, and emergency medical services should the gymnast/dancer require such assistance, transportation, or services as a result of injury or damage related to participation in the Activity. If the gymnast/dancer is a minor and a parent or guardian is not present, efforts will be made to contact a parent or guardian that are reasonable under the circumstances, but treatment will not be withheld if a parent or guardian cannot be reached.
I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage which I consider adequate for the participant's protection. This consent shall remain effective until one year from the date below unless sooner revoked in writing and delivered to Donna's Gym, Inc. DBA: South County Movement Center.